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By Madonna Behen

It's cold and flu season, which means plenty of moms are facing that age-old parenting dilemma: Do I send my coughing, sniffly child to school? And if I make the wrong choice, will the school nurse call a few hours later asking me to take him back home?

Figuring out when to keep your child home from school and when he's well enough to go back isn't always easy, says Dr. Loraine Stern, associate clinical professor of pediatrics at UCLA School of Medicine in California.

"The truth is, you can't always tell how sick a child really is," says Stern. For instance, some kids may seem totally fine at breakfast but take a quick turn for the worse and end up very sick two hours later.

What to Do With a FluOf course, when it comes to such flu symptoms as high fever, vomiting and body aches, the answer is a no-brainer. "If your child is running a fever, you should keep her home because she's not going to be able to sit at her desk and pay attention," says Stern. This applies to seasonal flu as well as H1N1 virus (swine flu), she adds.

What to Do With a ColdWhen your child has run-of-the-mill cold symptoms like a runny nose and cough, deciding whether to send or keep him home isn't always cut and dry, says Stern. "Let's face it, if you wait for children to have noses that are completely clear, they're never going to go to school," she says.

So, as long as your child doesn't have a fever and is acting normal, it's fine to send him to school with a minor cold. Even nasal discharge, as unpleasant as it may be, isn't reason enough to keep a child home.

"Young children often have this at the end of a cold, and it's perfectly normal and not contagious," says Stern. "If the discharge goes on for seven to 10 days, it may be a sign of a sinus infection, but that's not something that's contagious either."

On the other hand, a cough that's bad enough to disturb other kids in the classroom is a good reason to keep a child home.

More Signs to Stay Home Some signs to stay home are more clear-cut. For example, keep your child home if she has a highly contagious infection such as strep throat or conjunctivitis, says Stern. With strep throat, kids need to be on antibiotics for 24 hours before they can return to school. But with conjunctivitis (pinkeye), kids need only be under treatment, and they can go back to class. "That means the condition is getting better with medication but not necessarily cleared up yet," says Stern.

Since ear infections are not contagious, there's no reason to keep your child home when she has one, even if she's taking antibiotics. "Yet the current thinking is that the majority of ear infections get better by themselves without antibiotics," notes Stern.

Have symptoms (such as diarrhea) that disrupt activities or distract classmates (such as a hacking cough).

Send your children to school if they:

Had a fever that has been gone for 24 hours.

Are alert and able to pay attention in class.

Don't require a teacher to provide extra care.

And if you do have a sick child at home, try to see the silver lining. "Enjoy the time at home with him," says Stern. "It's a chance to do the kinds of things you don't have a chance to do when everyone's so busy -- like curling up on the couch with your child in your lap and reading books together."

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